| Payment ID | 23368 |
|---|---|
| Date Created | 04/20/23 11:46 am |
| Created By | Gloria Jimenez |
| Service Request | 22085 |
| Application ID | 14906 |
| Authorization Number | |
| Applicant Information | |
| Name | Alyssa Lewis |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170601130 |
| Payment Type | Security Deposits, Pet Deposits and App Fees |
| Type of Service Request | Security Deposits |
| Provider Name | Veronica Kaluza |
| Provider Contact Person | same |
| Contact Email Address | Email hidden; Javascript is required. |
| Phone | (254) 644-2982 |
| Address of Client Unit | 389 S Charles St. Apt A Elm Mott, Texas 76640 Map It |
| Address for Payment | WHA 4400 Cobbs Dr. Waco, Texas 76710 Map It |
| Acceptable Method of Payment | Money Order |
| Payment Details | |
| Payment Amount | $750.00 |
| Bank Fees | No |
| Receipt Amount | $750.00 |
| Receipt Date | 04/12/2023 |
| Comments | security deposit paid |
| Receipt | 12-04-2023Lewis750.00.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | LRE |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 04/20/2023 |
